Axillary reverse mapping (ARM) in clinically node positive breast cancer patients

Background: Axillary reverse mapping (ARM) is a technique to map and preserve upper extremity lymphatic drainage during axillary lymph node dissection (ALND) in breast cancer patients. We prospectively evaluated the metastatic involvement of ARM-nodes in patients who underwent an ALND for clinically node positive disease following (neo)adjuvant chemotherapy (NAC) in comparison to patients in whom primary ALND was performed without NAC. Patients and methods: Patients with clinically node positive invasive breast cancer, confirmed by fine needle aspiration cytology and scheduled for primary ALND were enrolled in the study: Patients were separated into two groups: one group treated with NAC (NAC+ group) and one group not treated with NAC (NAC- group). ARM was performed in all patients by injecting blue dye into the ipsilateral upper extremity. During ALND, ARM-nodes were first identified and removed separately, followed by a standard ALND. Results: 91 patients were included in the NAC+ and 21 patients in the NAC- group. There was no difference in the ARM visualization rate between the two groups (86.8% for NAC+ group versus 90.5% for NAC- group, P = 0.647). In the NAC+ group 16.5% of the patients had metastatic involvement of the ARM-nodes versus 36.8% of the patients in the NAC- group (P = 0.048). Conclusion: The risk of metastatic involvement of ARM-nodes in clinically node positive breast cancer patients is significantly lower in patients who have received NAC. (C) 2014 Elsevier Ltd. All rights reserved

Two decades of axillary management in breast cancer

Background: Axillary lymph node dissection (ALND) in patients with breast cancer provides prognostic information. For many years, positive nodes were the most important indication for adjuvant systemic therapy. It was also believed that regional control could not be achieved without axillary clearance in a positive axilla. However, during the past 20 years the treatment and staging of the axilla has undergone many changes. This large population-based study was conducted in the south-east of the Netherlands to evaluate the changing patterns of care regarding the axilla, including the introduction of sentinel lymph node biopsy (SLNB) in the late 1990s, implementation of the results of the American College of Surgeons Oncology Group Z0011 study, and the initial effects of the European Organization for Research and Treatment of Cancer AMAROS study. Methods: Data from the population-based Eindhoven Cancer Registry of all women diagnosed with invasive breast cancer in the south of the Netherlands between January 1993 and July 2014 were used. Results: The proportion of 34 037 women staged by SLNB without completion ALND increased from 0 per cent in 1993-1994 to 69.0 per cent in 2013-2014. In the same period the proportion undergoing ALND decreased from 88.8 to 18.7 per cent. Among women with one to three positive lymph nodes, the proportion undergoing SLNB alone increased from 10.6 per cent in 2011-2012 to 37.6 per cent in 2013-2014. Conclusion: This population-based study demonstrated the radical transformation in management of the axilla since the introduction of SLNB and following the recent publication of trials on management of the axilla with a low metastatic burden

Aharonov-Bohm effect on columnar defects in thin graphite and graphene

International audienceWe studied Aharonov-Bohm effect on thin graphite single crystals containing columnar defects (nanoholes) produced by irradiation with heavy ions. The thickness of irradiated single crystals has been varied from 50 nm down to less then 1 nm by thinning the thicker samples with beam-plasma etching. For irradiated samples we found the existence of oscillating, field-periodic contribution of magnetoresistance with a periodicity corresponding to the flux quantum hc/e per area of nanohole independently of sample thickness. The results point to the significant contribution of Dirac fermions to the oscillating part of magnetoresistance and also to the existence of the edge states located near the nanohole perimeter